Golden Retriever Dog Forums banner
1 - 19 of 19 Posts

·
Registered
Joined
·
53 Posts
Discussion Starter · #1 ·
Hello, Neige was diagnosed as hypothyroid in November. Between then and now we have been working with the vet to find a dosage that works well with her. Right now we have her on "thyro-tabs" .4mg (which we cut in half) twice a day. With Neige at .2mg twice a day for 8 weeks (aprox) we have received her latest blood test results which were taken last Wednesday.

Neige is "a little on the high side" being 61 nmoles, when the normal range is said to be 50 nmoles.

Just wondering if we should leave her running a little high, since she is not showing any other issues at this time? Would you keep tinkering with the dosage, or leave it alone? I have read here that low thyroid for a Golden is really low, so is just a little high very serious?

Thank you for your thoughts.
 

·
Registered
Joined
·
1,358 Posts
There may be differing opinions on this, but our vet told us it's okay for the peak level (4-6 hours post pill) to run slightly high so that the trough level (lowest level right before second pill) doesn't drop too low. This is provided they show no signs of HYPERthyroidism (excessive panting, restlessness). Once our vet was happy with Brady's peak level, she tested the trough to make sure the levels didn't crash in between pills.
 

·
Registered
Joined
·
53 Posts
Discussion Starter · #3 ·
Thank you for the reply. I guess the thing that concerns me is that we had her blood taken at 5PM, and she was higher than the norm at that time. We have been giving Neige her pills at 7am and 7pm...so at 5PM this was a whole 10 hours since her last dosage and if she was in the high range at that time, I can't imagine how high she spikes at, immediately after taking her medications.

She is not showing any signs that might indicate that we are over-medicating her (panting, excessive drinking) She does whine more than I have ever noticed lately, and usually just before she eats.

I would be interested in hearing your replies given this new information.

Thank you,
 

·
Registered
Joined
·
43,252 Posts
bumping up
 

·
Registered
Joined
·
9,612 Posts
My dog's thyroid is fine, but mine had to be removed.

In people, a significantly high level can cause many problems but I don't know if that is the same with dogs. My Dr doesn't allow me to get out of the normal range at all. In fact, he isn't even happy if I get to the high side of normal.

I know a lot of people on here recommend Dr. Dobbs for thyroid issues/advice. If you don't get more advice, you could try running a search on her name for more information.
 

·
Registered
Joined
·
869 Posts
You had mentioned in your post that her blood was taken at 5 pm and her medication is given at 7 pm. When was the last time she had eaten?? Thyroid tests are supposed to be taken with dogs as fasting to be truly accurate. Also what is the age of your dog?? Goldens need their thyroid to be a little on the high side of normal for them to be functioning and truly healthy. You have to remember that the numbers that the vets use are for canines as a species and ther will be differences in the breeds and then differences in individuals.
 

·
Registered
Joined
·
215 Posts
I personally would want the thyroid more in the normal range. But I am curious as to what you vet has to say about this? Have you consulted with them? I would not tinker on your own, but follow the advice of your veterinarian for this.
 

·
Registered
Joined
·
2,286 Posts
How was your dog's hypothyroidism diagnosed? If based solely on T4, she may not really be hypothyroid at all. Many other illnesses can depress T4 levels (not all of which are bad diseases, things like allergies could depress T4 as well). One really needs a full 6 panel thyroid test to accurately diagnose hypothyroidism.

How big is your girl? I assume she's a golden retriever, so at least 50#. The usual dosage of thyroid meds is about 0.1mg per 10#. 0.2 twice daily is *really* low. And if her levels are high on that, I'd be tempted to talk with your vet about stopping the meds and retesting in 4-6 weeks with the full thyroid panel.
 

·
Registered
Joined
·
215 Posts
How was your dog's hypothyroidism diagnosed? If based solely on T4, she may not really be hypothyroid at all. Many other illnesses can depress T4 levels (not all of which are bad diseases, things like allergies could depress T4 as well). One really needs a full 6 panel thyroid test to accurately diagnose hypothyroidism.
This is good advice, I always assume doctors do an full panel, but true, maybe they didn't. My mom had trouble with this from her physician with her thyroid, and I thought, duh, why wouldn't you do the full thing?
 

·
Registered
Joined
·
53 Posts
Discussion Starter · #10 ·
Thank you

I want to thank you everyone who wrote words of wisdom. I will try to asnwer all the quesitons that were asked, please forgive if I miss one.

1) Neige is a Female Golden, spayed, 8 years old (Feb 1)
2) Neige is heavy, 96 lbs.
3) Neige has insurance, so we have been very good about getting all the tests done that are necessary. I cannot say at this time if she had the "full panel". I will say that she has had three seperate tests done, and we hve switched vets to get a second opionion. (The second vet looked at the results of the first vets and ordered a panel of her own, saying that we will test for other things as well...)
4) Neige gets her .2mg at 7am when I get up, her food bowl is also filled at this time, however she does not usually eat it right away. I would guess that the time since Neige ate her food and her blood was drawn to be about 8 hours. (Neige gets her second pill at 7pm)
5) Neige was diagnosed partly due to the bloodwork results, but also the way she was presenting. (Lethargy, weight gain, "tragic look)

Knowing this, do you still think that this may not be hypothyroid at all? I am interested in the comment about the dosage being low and asking the vet to stop the medication to re-test after 6 weeks.
 

·
Registered
Joined
·
2,286 Posts
First find out tomorrow exactly what test have been done.

Just for your information, here's one of the entries in Plumb's veterinary handbook as far as dosing/retesting hypothyroid using Levothyroxine Sodium (the other entries use a similar starting dose, but this one is a bit more detailed as to the retesting):

Initiate treatment at 22 micrograms/kg PO twice daily (0.1 mg/10 lbs body weight bid); reevaluate dosage after monitoring clinical response and serum levels after 4-8 weeks. If clinical response is satisfactory and T4 is elevated (> 60 nmol/L) may reduce dosage to 22 micrograms/kg once daily. If clinical response is not satisfactory, either reevaluate the need for T4 supplementation or increase the dose. Daily dosage of 20-40 micrograms/day appears to be adequate for most dogs. (Refsal and Nachreiner 1995)
So, a nearly 100# theorhetically should get 0.9-1.0 twice daily to start. Your dog responding to such a low dose makes one wonder. Talk to your vet!
 

·
Registered
Joined
·
53 Posts
Discussion Starter · #12 ·
Hello IowaGold, I took your advice and called the vet today. I mentioned the concerns that you brought forward (thank you)

The vet said that the calculation she uses was 11mg/Kilo...so I guess with the conversion this would bring us to roughly .473mg??? (not sure if my math is right) If I am right with the above calculation this would mean that the .4mg that Neige is taking is still low as the above .473 should be given 2 times a day, Neige gets this .4mg split into two.

I expressed the concerns that 10 hours after the dose she is still considered to be in the high range, the vet said that taking everything into consideration, she is slightly concerned, but would rather Neige be in the high range as opposed to the low (stating that she was only slightly high, but still sonsidered to be in the therapudic range.

The vet said that Neige was given the t4 biequalibrium dialisys and that test did indicate that she was hypo thyroid.

The vet would like to haev Neige wait 6 weeks and re-test. Please let me know your thoughts on this. i just want to make sure that we are dealing with the thyroid and not missing something else...Thanks.
 

·
Registered
Joined
·
2,286 Posts
So she did NOT have a full thyroid panel. And I assume you meant 11 micrograms rather than milligrams. I am still not sure where that starting dose came from. All the labels and drug books recommend 20-22 micrograms/kg, ie 0.02mg/kg, ie 0.01/pound or 0.1 per 10 pounds.

With the dosages/numbers you stated, I would (if she were MY dog), ask the vet about going off the meds for a month, then retesting with the appropriate panel (you need the T4, T3, free T4, Free T3, TSH, and Thyroglobulin Antibody). But she is not my patient, so my advice is worth what you paid for it! By all means follow your vet's advice, but it never hurts to educate yourself and ask intelligent questions.
 

·
Registered
Joined
·
53 Posts
Discussion Starter · #14 ·
Thank you for your reply. I guess I have two options:

1) Continue Neige on the path that she is on, knowing that she may not be hypothyroid at all- potentially masking other issues.

2) Take her off the meds and re-test with the 6 panel test to see if she is Hypothyroid for sure.

Worst case with number 1 is that we aren't identifying the issue and not treating the root cause of her initial problem which was weight gain, lethargy, what the vet called the "table top" (her flat looking back) and the dull looking coat.

Worst case with number 2 is that we are off the medication, she really has hypothyroid and we are not treating it for what would equate to about two months. (after we stop and restart the medication) Probabaly not helpful that we are stopping and restarting the meds either.

Knowing all of this you would still suggest stopping the medication for a month?

Ugg, gives me a lot to think about to make sure I do the right thing by Neige...:confused::confused::confused:

Funny thing, the Vet said that the t4 biequalibrium dialisys was the "Gold Standard amongst blood tests for hypothyroid" maybe not?
 

·
and now Mollie's mom too
Joined
·
1,268 Posts
I am going to share my experience with this. I too have a 8yr old female golden. Had her tested 2x by Michigan State Veterinary, one of the top. 2yrs ago and again in 2009. Both times the results were "low normal" and my vet didn't think any action was needed. I had heard that what was ok in one breed was not necessarily so for another, so I sent my test results to Hemopet in CA. (Dr. Jean Dodd) supposedly the "TOP" thyroid expert. Guess what? Low normal in golden's is a problem! Dr. Dodd recommended a 8 week trial for my dog. Dosage to be .2mg/ 10-12lbs twice daily either 1 hr before feeding or 3 hrs after, then retest after 8 weeks. Trial is now completed and retest showed that the medicine did make a difference. We will continue on with the medicine and retest again at the end of the year. I would suggest that you contact Dr. Dodd via email and discuss your dog with her. She is extremely good about replying to emails and the advice comes for free.
Not much is free these days!!!!!!
 

·
Registered
Joined
·
2,286 Posts
With my own dog, I would want the full panel, so would stop the meds and retest. I would be more concerned about over treatment than under treatment (since the under treatment would be for a relatively short amount of time). But you have to do what you are comfortable with.
 

·
Registered
Joined
·
53 Posts
Discussion Starter · #17 ·
Sorry, I checked and was not able to find Dr Dodd's email address...is there anyone here that can help me with that?

Thanks!
 
1 - 19 of 19 Posts
Top